16 Sep Does your child feel crushed when they get corrected, or left out? An OT perspective on Rejection Sensitivity Dysphoria
Have you ever watched your child fall apart after a simple “not now” or a bit of gentle feedback? Do they seem to overreact when they’re left out, or become deeply upset by something that feels small to others? If so, your child may be experiencing something called Rejection Sensitivity Dysphoria, or RSD.
RSD isn’t an official diagnosis, but it’s a term often used to describe extreme emotional responses to real or perceived rejection, criticism, or failure. It’s particularly common in children with ADHD, autism, or sensory processing differences, though any child can be affected.
As a paediatric occupational therapist, I regularly support children who are bright, kind, and full of potential, yet feel crushed by what might seem like everyday moments: not being picked in a game, a friend not responding to a message, or a teacher asking them to redo their work.
These children aren’t being dramatic or defiant. Their nervous systems are on high alert, and social rejection, even imagined, feels genuinely threatening. Their reactions may seem “over the top”, but they’re very real to them.
So, how can we support them?
- Validate their feelings, even when their response seems disproportionate.
- Stay calm and present – your nervous system helps to regulate theirs.
- Use clear, gentle communication – avoid sarcasm or sharp tones.
- Give them a heads-up before offering feedback: “Can I give you a tip before we try again?”
- Practice resilience through role-play, sensory tools, and safe routines.
Occupational therapy can help children with RSD build the skills they need to manage big emotions. We focus on emotional regulation, social understanding, and nervous system support. We also guide parents in recognising triggers and creating proactive strategies at home.
Above all, remember this: your child isn’t “too sensitive”, they feel deeply. With the right tools and understanding, they can learn to process emotions safely and feel more confident in the world around them.
If this sounds familiar, you’re not alone. With the right support, things can get easier, for your child and for you.